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Researchers at Stanford University selected 18 EKGs, 8 from patients with normal hearts and 10 from patients with any of six different abnormalities that commonly underlie sudden cardiac death. The scientists showed the EKGs to 53 experienced pediatric cardiologists to see if they could make the correct diagnosis, properly restrict or allow athletic activity, and order appropriate follow-up tests. The correct diagnosis and recommendations were based on the report of two electrophysiologists, cardiologists who specialize in interpreting EKGs.        </p><p>
The cardiologists correctly identified only 68 percent of truly abnormal cases &mdash; 32 percent of teenagers with abnormal EKGs were never detected. And of the cases the doctors did identify as abnormal, 30 percent were actually normal.        </p><p>
&ldquo;One of the most striking findings was the inability of the cardiologists to give correct sports guidance,&rdquo; said Dr. Anne M. Dubin, an associate professor of <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/pediatrics/index.html?inline=nyt-classifier" title="Recent and archival health news about pediatrics." class="meta-classifier">pediatrics</a> at Stanford and lead author of the new study. Twenty-six percent of patients who should have been allowed to exercise were not, and 19 percent of patients who should have been restricted were not, she noted.        </p><p>
<a title="Full study. [pdf]" href="http://www.jpeds.com/webfiles/images/journals/ympd/JPEDSHill.pdf">The report</a> appeared online on Thursday in The Journal of Pediatrics. Dr. Dubin has received fellowship support from Medtronic Inc., a manufacturer of medical equipment.        </p>
<p>Now, scientific advances are producing approaches that could pass muster. Prompted by women&rsquo;s organizations, global health groups and surveys indicating that men are receptive, federal agencies are financing research. Some methods will be presented at an October conference sponsored by the Bill and Melinda Gates Foundation.        </p><p>
&ldquo;Male contraception is a critical area,&rdquo; said Jenny Sorensen, a foundation spokeswoman. &ldquo;It doesn&rsquo;t make sense to not include everyone in the discussion.&rdquo;        </p><p>
The most studied approach in the United States uses <a href="http://health.nytimes.com/health/guides/test/testosterone/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Testosterone." class="meta-classifier">testosterone</a> and progestin hormones, which send the body signals to stop producing sperm. While effective and safe for most men, they have not worked for everyone, and questions about side effects remain.        </p><p>
So scientists are also testing other ways of interrupting sperm production, maturation or mobility.        </p><p>
One potential male birth control pill, gamendazole, derived from an anticancer drug, interrupts sperm maturation so &ldquo;you&rsquo;re making nonfunctional sperm,&rdquo; said Gregory S. Kopf, associate vice chancellor for research administration at the University of Kansas Medical Center. The center has begun discussions with the Food and Drug Administration about the drug, already tested in rats and monkeys.        </p><p>
Dr. John K. Amory, a reproductive scientist at the University of Washington, is studying a drug that was developed for worm infections and was later tried on men because it caused infertility. Using rabbits, Dr. Amory said, he discovered the drug blocks production of retinoic acid, important for sperm production.        </p><p>
Unfortunately, the drug acts like one for curbing <a href="http://health.nytimes.com/health/guides/disease/alcoholism/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Alcoholism." class="meta-classifier">alcoholism</a>, so drinking when taking it makes people sick. Dr. Amory is working to make it cocktail-compatible.        </p><p>
&ldquo;The joke,&rdquo; he said, &ldquo;is if it weren&rsquo;t for alcohol, no one would need contraception.&rdquo;        </p><p>
Debra J. Wolgemuth, a geneticist at the Columbia University Medical Center, is testing in mice another drug that inhibits retinoic acid without alcohol interactions. Bristol-Meyers Squibb developed it for skin diseases, but found it was &ldquo;a testicular toxin.&rdquo;        </p><p>
At Harvard, Dr. David Clapham, a neurobiologist, discovered that sperm tails contain <a href="http://health.nytimes.com/health/guides/test/serum-calcium/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Serum calcium." class="meta-classifier">calcium</a> ion channels, with electrically charged atoms &ldquo;turbo-charging the sperm&rdquo; to reach eggs, he said. He is developing a drug to disable the channel.        </p><p>
&ldquo;You just turn off the motor, rather than alter the people in a car,&rdquo; he explained.        </p><p>
Elaine Lissner, director of the Male Contraception Information Project, formed a foundation to develop other approaches. One, &ldquo;reversible inhibition of sperm under guidance,&rdquo; or Risug, involves injecting gel into the scrotum to inactivate sperm. Another involves briefly heating the testes with <a href="http://health.nytimes.com/health/guides/test/ultrasound/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Ultrasonics." class="meta-classifier">ultrasound</a>, which can halt sperm production for months, she said.        </p><p>
&ldquo;I can imagine a world where you take your car in every six months to get your oil changed and go next door and get your ultrasound for 50 bucks,&rdquo; she said.        </p><p>
American scientists will remain skeptical unless research shows Risug is reversible, or ultrasound effective.        </p><p>
There are also two drugs, an antihypertensive and an antipsychotic, each found to keep men from ejaculating during orgasm. The drugs would need modifications not to affect <a href="http://health.nytimes.com/health/guides/disease/hypertension/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Hypertension." class="meta-classifier">hypertension</a> or mood.        </p><p>
Of course, women may have to trust that their partners are using birth control, as men do now. But at least one method, hormone implants, visibly bulge from a man&rsquo;s bicep. &ldquo;Guys like it because they can show it off,&rdquo; Dr. Amory said. &ldquo;Proof that the male is contracepting.&rdquo;        </p><p>
Pharmaceutical companies have not yet embraced any method, waiting for something as effective as female methods and risk-free enough to give to healthy men.        </p>
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